- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,042.22 / $7,253.13 / $13,642.00
| Facility | | $5,042.22 | $7,253.13 | $13,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,134.14 / $6,695.51 / $8,290.40
| Facility | | $5,134.14 | $6,695.51 | $8,290.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,358.00 / $6,528.54 / $11,059.49
| Facility | | $4,358.00 | $6,528.54 | $11,059.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,245.54 / $7,728.35 / $11,112.42
| Facility | | $6,245.54 | $7,728.35 | $11,112.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,805.38 / $14,615.00
| Facility | | $3,952.00 | $7,805.38 | $14,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $7,593.55 / $10,411.31
| Facility | | $3,952.00 | $7,593.55 | $10,411.31 |